摘要
目的探讨缺铁性贫血(iron deficiency anemia,IDA)患者的血清铁蛋白(serum ferritin,SF)、血红蛋白(Hemoglobin,HB)和血清甲状腺激素水平之间的关系。方法回顾性分析190例确诊的IDA患者,按贫血程度分为轻度、中度、重度组,按甲状腺功能分甲状腺功能亢进组、亚临床甲状腺功能亢进组、临床甲状腺功能减退组、亚临床甲状腺功能减退组及甲状腺功能正常组,所有研究对象均行血常规、血清铁蛋白、甲状腺激素水平测定。结果IDA伴甲状腺功能异常占43.2%,IDA合并亚临床甲减占45.1%、甲状腺毒症占29.3%、临床甲减占15.9%、亚临床甲亢占9.8%,IDA与甲状腺疾病的患病率有统计学意义(P<0.01)。轻度、中度、重度IDA合并甲状腺功能异常的分别占47.4%、33.3%、60%;其中轻度IDA患者合并临床甲亢、亚临床甲亢、甲减、亚临床甲减的患病率分别为75%、75%,38%,43.2%,中度:20.80%、12.50%、30.80%和40.50%,重度:4.20%、12.50%、30.80%和16.20%,IDA的严重程度与甲状腺疾病的患病率有统计学意义(P<0.05)。相关性分析显示,在IDA患者合并甲减、亚临床甲减时,HB与游离三碘甲状腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)均有相关性(P<0.01),SF仅与TSH有相关性(P<0.05)。在IDA患者合并临床甲亢和亚临床甲亢时,SF、HB分别与FT_(3)、TSH有相关性(P<0.05),与FT_(4)无相关(P>0.05)。甲状腺功能正常的IDA患者,SF与FT_(3)、FT_(4)和TSH有相关性(P<0.01),HB仅与FT_(4)有相关性(P<0.01)。结论IDA可以导致甲状腺激素的变化,SF、HB与FT_(3)、FT_(4)、TSH之间存在相关性;IDA伴亚临床甲减患病率更高,以轻、中度贫血较多见,血红蛋白相较于铁蛋白能更好地反应IDA合并亚临床甲减的指标。
Objective To explore the relationship among serum ferritin(SF),hemoglobin(HB),and serum thyroid hormone levels in pa⁃tients with iron deficiency anemia(IDA).Method A retrospective analysis was conducted on 190 confirmed IDA patients,who were di⁃vided into mild,moderate,and severe groups according to the degree of anemia.They were divided into hyperthyroidism group,subclini⁃cal hyperthyroidism group,clinical hypothyroidism group,subclinical hypothyroidism group,and normal thyroid function group according to thyroid function.All study subjects underwent blood routine,serum ferritin,and thyroid hormone levels measurements.Results IDA with thyroid dysfunction accounted for 43.2%,IDA with subclinical hypothyroidism accounted for 45.1%,thyrotoxicosis accounted for 29.3%,clinical hypothyroidism accounted for 15.9%,and subclinical hyperthyroidism accounted for 9.8%.The incidence of IDA with thy⁃roid diseases was statistically significant(P<0.01).Mild,moderate,and severe IDA with thyroid dysfunction accounted for 47.4%,33.3%,and 60%,respectively;The prevalence rates of mild IDA patients with clinical hyperthyroidism,subclinical hyperthyroidism,hy⁃pothyroidism,and subclinical hypothyroidism were 75%,75%,38%,43.2%,moderate:20.80%,12.50%,30.80%,and 40.50%,and se⁃vere:4.20%,12.50%,30.80%,and 16.20%,respectively.The severity of IDA was statistically significant with the prevalence of thyroid diseases(P<0.05).Correlation analysis showed that in IDA patients with hypothyroidism and subclinical hypothyroidism,HB was corre⁃lated with free triiodothyronine(FT_(3)),free thyroxine(FT_(4)),and thyrotropin(TSH)(P<0.01),while SF was only correlated with TSH(P<0.05).In IDA patients with clinical hyperthyroidism and subclinical hyperthyroidism,SF and HB were correlated with FT_(3) and TSH,re⁃spectively(P<0.05),but not with FT_(4)(P>0.05).In IDA patients with normal thyroid function,SF was correlated with FT_(3),FT_(4),and TSH(P<0.01),while HB was only correlated with FT_(4)(P<0.01).Conclusions IDA can lead to changes in thyroid hormones,and there is a correlation between SF,HB and FT_(3),FT_(4),and TSH;The incidence of iron deficiency anemia with subclinical hypothyroidism is higher,with mild to moderate anemia being more common.Hemoglobin can better reflect the IDA with subclinical hypothyroidism compared to ferritin.
作者
李金贺
徐丹
LI Jinhe;XU Dan(School of Clinical Medicine,Beihua University,Jilin City,Jilin Province 132011;Affiliated Hospital of Bei-hua University,Jilin City,Jilin Province 132011,China)
出处
《吉林医药学院学报》
2024年第2期116-119,共4页
Journal of Jilin Medical University
基金
吉林省教育厅科学技术研究项目(JJKH20210051KJ)。
作者简介
李金贺(1996-),女,吉林省吉林市人,住院医师,硕士研究生,主要从事血液肿瘤学研究。;通信作者:徐丹,副主任医师(E-mail:xudan.net@163.com)。
